Applying Latent Variable Modeling to Cormorbidity Treatment Research

描述（由申请人提供）：此K02申请的目的是允许候选人将他分配给研究和相关职业发展活动的时间从没有K02的预计年平均25-45%增加到有K02的75-80%。该申请概述了候选人15年的NI/\ aa支持的酒精研究历史，并提供了一个职业发展计划，旨在获取和部署复杂的数据分析和方法策略，这些策略属于潜在变量结构方程建模（LV-SEM）的广泛主题（例如，因子分析，路径分析，潜在类别和特征建模，生长混合建模，项目反应理论）。这将通过具体的职业发展目标来实现，包括：1)与导师和合作者的互动（15%）；2)假设检验（25%）；3)正规课程/培训（25%）；4)学术成果（25%）；5)教学/服务（10%）。“父母R01”（“共病酒精焦虑症的CBT治疗”/\A0105069）以400名接受标准社区酒精中毒治疗计划的患者为样本，这些患者也被诊断患有几种常见共病焦虑和情感（“内化”）障碍中的至少一种。除了酒精治疗外，患者还接受两种心理治疗中的一种来治疗内化障碍。LV-SEM将允许候选人根据经验将母体R01数据集中高度相互关联的内化障碍/症状划分为不同的组件和共同的组件，然后在因果模型中与酒精和内化治疗结果相关。接下来，候选人将在社区、学生和基于精神病学的数据集中复制这些模型，这些数据集要么是公开的（例如，NESARC），要么是通过他的合作者(例如，dr。肯·谢尔和嘉莉·兰德尔)。这些努力将对酒精使用障碍患者所经历的内化问题以及这些问题如何与酗酒和精神治疗在许多人群和治疗方式之间的关系提供经验上的简明描述。长期目标将是开发更有效的治疗酒精障碍与共病的内化障碍。相关性：通过进一步明确酒精中毒治疗患者发生内化障碍的最佳临床策略和概念化，本研究将提高我们有效治疗酒精依赖的能力。

DESCRIPTION (provided by applicant): The objective of this K02 application is to allow the candidate to increase the time he has allocated to research and related career development activities from a projected annual average of between 25-45% without the K02 to between 75-80% with the K02. The application overviews the candidate's 15-year history of NI/\AA-supported alcohol research and provides a career development plan aimed at acquiring and deploying sophisticated data analytic and methodological strategies that fall under the broad heading of latent variable-structural equation modeling (LV-SEM) (e.g., factor analysis, path analysis, latent class and trait modeling, growth mixture modeling, item response theory). This would be accomplished via specific career development objectives involving: 1) interactions with mentors and collaborators (15%); 2) hypotheses testing (25%); 3) formal courses/training (25%); 4) scholarly production (25%); and, 5) teaching/ service (10%). The "parent R01" ("CBT Treatment of Anxiety Disorders in Comorbid Alcoholics" /\A0105069) targets a sample of 400 patients undergoing a standard community-based alcoholism treatment program who are also diagnosed with at least one of several common comorbid anxiety and affective ("internalizing") disorders. In addition to the alcohol treatment, patients receive one of two psychosocial treatments for internalizing disorder. LV-SEM would allow the candidate to empirically partition highly inter- correlated internalizing disorders/symptoms in the parent R01 dataset into distinct vs. common components that could then be related in causal models to the alcohol and internalizing treatment outcomes. Next, the candidate would replicate these models in community, student and psychiatric-based datasets that are either publicly available (e.g., NESARC) or available via his collaborators (e.g., Drs. Ken Sher and Carrie Randall). These efforts would provide an empirically parsimonious characterization of the internalizing problems experienced by individuals with alcohol use disorders and how these relate to alcoholism and psychiatric treatments across a number of populations and treatment modalities. The longer-term goal would be to develop more effective treatments for alcohol disorders with comorbid internalizing disorders. RELEVANCE: By further clarifying the best clinical strategies for and conceptualization of internalizing disorders occurring in alcoholism treatment patients, the proposed work will improve our ability to effectively treat alcohol dependence.